Understanding Autism

Understanding And Treating Autism

Whenever a doctor informs the parents that their child is suffering with Autism, the first & foremost question that is thrown over him is - How did it happen? How did my child get this disease? Well, there is no definite answer to what are the exact causes of Autism.

Autism Support Program

By Wilbur Mitch on Fri, 12 Oct 2018

Finding out that your beloved child has autism can be one of the most sinking feelings that you've ever had. You feel helpless at the fact that your child may not be able to do many of the things that other children the same age can do. Biomedical therapy research has however shown that autism is not always something that will stay forever the same way. Biomedical therapy has been show to help children with autism in ways that have never before been available. There are six steps to the plan to cure your child: Reduce the toxic load your child is experiencing, heal the digestive system, increase body nutrient levels, support metabolism and biochemistry, remove heavy metals and toxins, and optimize long-term health. While this will not cure autism per se, you will be able to help your child live a better quality of life because of it. And don't they deserve as good a quality of life as anyone else?

Autism Support Program Summary

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Some parents don't want to hear or use the A-word in connection with their children. Even though the current term for autism is ASDs, most doctors and professionals still use the word autism. This can be devastating because, for many people, autism carries a stigma. I was one of those parents who was initially uncomfortable with using the A-word. For me, it was less about admitting it to the world and more about admitting it to myself. I could not stand to hear myself say that my son had autism, so I continued to say that Jake had been diagnosed with PDD-NOS. When someone asked me what I meant, I offered an explanation that included the term developmental disorder, carefully avoiding the A-word. During this time, I was on the phone with the father of a child with an ASD. He kept referring to Jake as having autism. When I finally corrected him, he responded by saying, PDD-NOS, PDD, call it what you will it's all autism. Besides, he joked, autism is easier to say. I listened to him use...

A paradigmatic example of a potentially useful neuropeptidergic intervention strategy (as well as the attending conceptual and pragmatic problems) can be highlighted by summarizing past attempts to utilize opiate antagonists in the treatment of autism. As already noted, the opioid linkage to autism was initially based on the striking similarities between classic autistic symptoms and those produced by injection of opioid drugs including decreased separation distress, decreased gregariousness, decreased pain sensitivity, and increased stereotypies and rough-and-tumble play (Panksepp and Sahley, 1987). There are a host of methodological concerns that need to be considered in future trials. First, autism is not a single brain disorder, and only a subset of children might respond to naltrexone. Thus, one should first aspire to identify drug responders and then to conduct double-blind studies on them to maximize the characterization of therapeutic trends. Further, since opiate antagonists...

No matter where you live in the world, you can always access information about ASDs through the Internet, or through your local organization for autism. This list was compiled courtesy of the National Autistic Society. The National Autistic Society is the United Kingdom's foremost organization for people with autism and those who care for them, spearheading national and international initiatives and providing a strong voice for autism. The organization works in many areas to help people with autism live with as much independence as possible. The NAS exists to champion the rights and interests of all people with autism and to ensure that they and their families receive quality services appropriate to their needs. The NAS website includes information about autism spectrum disorders and support and services available in the United Kingdom. NAS has comprehensive services and resources that include autism accreditation, diagno THE INTERNATIONAL ASSOCIATION AUTISM EUROPE Telephone +32 (0) 2...

Autism and Asperger's Disorder are childhood disorders usually diagnosed before age three and marked by striking and enduring impairment in interpersonal and social interactions. Autism symptoms include social interaction deficits (e.g., impairment in such nonverbal behavior as eye contact, facial expression, posture, Asperger's Disorder differs from Autism in that the child uses language, probably in an eccentric way, but misses social cues from others. There is no clinically significant delay in language acquisition and less repetitive motor behaviors.

Autism Spectrum Disorders The Facts, Theories, Studies, and Information You Should Know 71 Appendix A Modified Checklist for Autism in Toddlers (M-CHAT) 277 Appendix C Treatments and Interventions for Autism Spectrum Disorders 285 Appendix D National Organizations for Autism in the United States 309 Appendix E International Organizations for Autism 316 Although autism was first defined by psychiatrist Leo Kanner more than sixty years ago, it has only been in the last decade that public interest in this developmental disorder has so dramatically increased. There is more research and a greater knowledge about the importance of intervention than ever before. As public awareness has increased, more cases of autism have been identified, and autism is now being diagnosed earlier in life. Whereas a four-year-old child with autism used to be considered a young case, specialized centers are now seeing children between the ages of twelve and eighteen months fairly...

Sam was a full-term baby who appeared normal and healthy at birth. According to his mother, aside from a little colic, Sam's first year of life was uneventful. By age 18 months, however, Sam's family became concerned over his increasing lack of social responsiveness, poor eye contact, and failure to acquire any meaningful speech. When brought to the attention of the family pediatrician, the parents were told not to worry since all children develop differently. By age 2, however, Sam's parents become increasingly alarmed by his continued language delays, as well as by his frequent tantrums, lack of play skills, and strange behaviors (for example, staring at lights and waving his fingers in front of his eyes). Family life was further disrupted by Sam's chronic sleep problems, extreme mood fluctuations, and refusal to eat most foods. Finally, at their wit's end, Sam's parents brought him for an evaluation at a nearby children's hospital. After several days of testing, they were informed...

For other disorders, there appear to be deficits of imagination, most notably in the autism spectrum disorders. A deficit in imagination is widely considered to be one of the triad of symptoms that characterizes people with autism (the other two being problems with socialization and communication). In general, research on autism spectrum disorders has been very informative about typical and atypical functioning, and has the potential to provide new insights about imagination. There is still much to learn about how imagination functions in individuals on the autism spectrum, but some of research findings suggest connections with the topics discussed in this essay. For example, children on the autism spectrum tend to not spontaneously engage in pretend play. However, they have less difficulty comprehending the pretend acts of others than producing their own, which suggests their difficulty is in generating play ideas rather than difficulty understanding the underlying representations....

Autism is a developmental disability involving difficulties with communication and social interaction as well as unusual and restricted behavior. The prevalence of autism appears to be rapidly increasing, for reasons not yet clear (Fombonne, 2003 Yeargan-Allsopp et al., 2003). The latest prevalence estimates are 1.1 per 100 children (Kogan et al., 2009). This makes it essential that any primary care physician seeing children be able to recognize signs and symptoms suggesting autism and refer for further evaluation promptly. Early diagnosis allows earlier initiation of intensive behavioral intervention, which has been shown to be very helpful (Butter et al., 2003). Table 23-11 lists red flags that should prompt referral for further evaluation Screen for autism if language delayed Modified from Filipek PA, Accardo PJ, Ashwal S, et al. Practice parameter screening and diagnosis of autism. Neurology 2000 55 468-479. (Filipek et al., 2000). A formal audiology evaluation is also indicated,...

Autism is a pervasive developmental disorder. This means that autism is characterized by specific delays and deviance in social, communicative, and cognitive development that are typically manifested within the first few years of life. Although often associated with mental retardation, the disturbances in these domains are both qualitatively distinct from and quantitatively disproportionate to the mental age intelligence quotient (IQ) of the individual who exhibits them. The diagnostic criteria for autism currently emphasize disturbances in three broad areas of developmental dysfunction. These include (1) qualitative disturbances in social interaction, such as impaired use of nonverbal behaviors, failure to develop peer relationships, and poor social reciprocity (2) qualitative disturbances in communication, such as a significant delay in the development of spoken language, an inability to sustain a spoken conversation, stereotyped use of language, or paucity of symbolic or imitative...

AUTISM A condition marked by developmental delay in social skills, language, and behavior. Can present itself in varying degrees of severity. AUTISM BEHAVIOR CHECKLIST (ABC) A method of measuring the level of autistic behaviors in individuals by giving each autistic behavior a weighted score. AUTISTIC SAVANT A person who expresses extraordinary mental abilities, often in the fields of numerical calculation, art, or music, but usually set within the context of autism or mental retardation. AUTISM SPECTRUM DISORDERS Encompasses the following five disorders as defined in the DSM-IV-TR Autistic Disorder, Asperger's Disorder, Childhood Disintegrative Disorder, Rett's Disorder, and Pervasive Developmental Disorder-Not Otherwise Specified (see Appendix B). CHILDHOOD AUTISM RATING SCALE (CARS) A test developed at TEACCH to diagnose autism. The child is rated in fifteen areas of ability, resulting in an assessment of nonautistic, autistic, or severely autistic. GILLIAM AUTISM RATING SCALE...

Temple Grandin's book Thinking in Pictures And Other Reports from My Life with Autism, offered me insight into what Jake may have been experiencing From as far back as I can remember, I always hated to be hugged. I wanted to experience the good feeling of being hugged, but it was just too overwhelming. It was like a great all-engulfing tidal wave of stimulation, and I reacted like a wild animal. Being touched triggered flight it flipped my circuit breaker. I was overloaded and would have to escape, often by jerking away suddenly.

In addition to experiencing auditory and tactile sensitivities, a smaller percentage of children with ASDs may be overly sensitive to taste and smell. In a survey of sensory problems in children and adults with autism, Neil Walker and Margaret Whelan of the Geneva Center in Toronto found that 80 to 87 percent of the subjects had hypersensitivity to touch or sound, while only 30 percent had hypersensitivity to taste and smell.10 In her book The Autism Spectrum A Parent's Guide to Understanding and Helping Your Child, Dr. Lorna Wing explains that eating problems may stem from feeding problems because some children have trouble controlling the muscles used for chewing and swallowing.11 Many children with ASDs are difficult to wean because they don't know how to eat lumpy food or food that requires chewing.

One of the mothers I contacted told me about her daughter Anna, who was diagnosed with autism twenty-five years ago. After years of intensive treatment, Anna, who is now thirty years old, went to college and is an MIT graduate. Both Anna and her mother are extremely proud of her accomplishments, but one thing still puzzles them Despite her high level of intelligence, Anna continues to take things quite literally. She does not understand expressions such as I almost died laughing and has trouble interpreting e-mails at work that include phrases like change for the better and bottom line. Her mother recalls Anna's frustration as a little girl when she read nursery rhymes to her. How can the cup run away with the spoon she'd ask, practically in tears. To this day, Anna does not understand all idioms, but she has been taught enough to be able to get by in the world. Through treatment, many children with ASDs can be taught to understand idioms. In her book Autism Explaining the Enigma, Uta...

Lorna Wing has found that among people with Asperger's and high-functioning autistic disorder, the ratio of boys to girls is 15 1. But Dr. Wing In 1964, Bernard Rimland conducted studies that showed boys tend to be more vulnerable to hereditary diseases and infections than girls, demonstrating that boys are more susceptible to organic damage than girls. In 2000, Dr. David Skuse of the Institute of Child Health in the United Kingdom concluded that the gene or genes for ASDs are located on the X chromosome. Since boys only inherit one X chromosome from their mother and girls inherit two X chromosomes, one from each parent, the hypothesis is that girls carry an imprinted gene from their fathers that may protect them from ASDs and, therefore, make them less likely than boys to have the disorder.12 A team of geneticists at UCLA have located the probable region of an autism gene on chromosome 17, which they discovered contributes to autism only in boys. This may be the reason why girls...

Autism has been called the fastest growing developmental disorder, and its impact is reflected in the amount of money that is spent in the United States on research, treatment, and education. According to the ASA, the annual cost of ASDs is 90 billion. Ninety percent of those costs currently occur in adult services. Through early diagnosis and early intervention, the cost of lifelong care can be reduced by two-thirds. Yet, it is estimated that the annual cost of ASDs in ten years will be 200 to 400 billion.16

Gary Goldstein, M.D., child neurologist and president of Baltimore's Kennedy Krieger Institute says, I think you can compare it to the progress that's been made in cancer research and treatment. At one point there was no cure for cancer. Now, there are subtypes of cancer that are curable and some that, so far, are not. We will most likely find subtypes of autism that will respond to treatment, and others that will take longer. The brain is so mysterious, and the disorder is so baffling. It will be a slow process. But will we get there Absolutely.17

According to the NRC, Services should include a minimum of 25 hours per week, 12 months a year in which the child is engaged in systematically planned, and developmentally appropriate educational activity toward identified objectives. What constitutes these hours, however, will vary according to a child's chronological age, developmental level, specific strengths and weaknesses, and family needs. Each child must receive sufficient individualized attention on a daily basis so that adequate implementation of objectives can be carried out effectively. The priorities of focus include functional spontaneous communication, social instruction delivered throughout the day in various settings, cognitive development and play skills, and proactive approaches to behavior problems. To the extent that it leads to the acquisition of children's educational goals, young children with an autism spectrum disorder should receive specialized instruction in a setting in which ongoing interactions occur...

Many parents find themselves in highly emotional states as a result of their children's diagnoses (I certainly did), which can make them want to postpone the search for treatments or cloud their abilities to make a decision. If you are having trouble coping emotionally, there are many options available to help you through this often stressful and difficult time. Talk to friends, seek out professional help, or consult with professionals on ASDs or autism organizations for advice (see Appendices D and E for a list of national and international organizations and Appendix F for resources where you can access information about local support groups). You'll also find good coping tips in Part III Coping. The best way to begin the process of deciding what treatment is right for your child is to consider the treatment recommendations made by the doctor or professional who diagnosed and evaluated your child. Recommendations usually include more than one treatment based on your child's needs,...

If you do make the choice to pay out-of-pocket for treatments (in the case of most alternative treatments, it's a forced choice), be careful. Many desperate parents who have made initial snap decisions to take on the costs of their children's treatments privately have regretted it later. It's not easy to see in the beginning just how much treatment costs can add up over time. Treatment sessions are usually billed on an hourly basis and range from 40 to 150 per hour. Intensive six- or eight-week programs may require extensive travel, a full- or half-time daily commitment, and cost thousands of dollars. Home programs and special schools for autism can cost between 25,000 and 80,000 per year. In your search for treatments and treatment providers, be aware of large upfront costs or large discrepancies in fees for the same services.

Walk through the school setting and imagine seeing it through your child's eyes. Is it free of distractions that may trigger an outburst from your child The environment should be positive, highly supportive, and conducive to meeting your child's specific needs. Will your child receive one-on-one treatment, group treatment, or a combination of both How is progress measured and how often Be sure there are standard assessments in place to measure your child's progress on a regular basis. What is the class size You'll want a small class with a teacher student ratio of no more than 1 3 so that your child can receive as much individual attention as possible. What is the makeup of the class Is it a general special needs class that's made up of children with various disorders, or is it exclusively a class for children on the autism spectrum If it is a general special needs class, make sure the teacher has experience and training in working with children with ASDs. If the school is exclusively...

From my experience working as a consultant to families of newly diagnosed children on the autism spectrum, I've learned that even those parents who receive specific treatment recommendations from their doctors or other professionals still try to find out about each and every treatment that exists for ASDs. I know that's what I did. Therefore, to save you the trouble of wading through countless books and websites to find out what these treatments are, I've compiled a list of treatments with brief descriptions of each in Appendix C. (Keep in mind that this is a comprehensive list, not a recommended list, of treatments simply to let you know what's available.) There are also two newly founded organizations that will be offering treatment recommendations in the near future for parents and professionals The Autism Treatment Network (ATN) and The Studies to Advance Autism Research and Treatment Network (STAART). ATN is a national nonprofit organization of hospitals and physicians from six...

Pivotal Response Training (PRT) is gaining recognition as one of the newer treatments for children with ASDs. Drawing on more than twenty years of research experience, Doctors Robert and Lynn Koegel, cofounders of the Autism Research Center at the University of California, Santa Barbara, have expanded upon the principles of Applied Behavioral Analysis to develop a comprehensive approach to working with children with ASDs. In pivotal response training, specific behaviors, known as pivotal behaviors, are seen as central in affecting general areas of functioning. By changing these pivotal behaviors, it is believed that other associated behaviors will change without being specifically targeted.

Placement refers to the program or class to which your child will be assigned. Among the options available are an integrated class, a special education class within a regular school, a special education school, a school designed specifically for children with autism, and or a home-based program.

It is important that you contact the closest early intervention state office as soon as possible after you come to suspect that your child has a problem or has received a diagnosis of an ASD. Early intervention is available in every state but may be administered by different state agencies. If you're not sure how to get in touch with the early intervention office, you can call your local school district or the National Information Center for Children and Youth with Disabilities for a contact in your state. Other informational contacts include the state or local Department of Human Services, local chapters of autism organizations, the local Department of Health, or local developmental disabilities associations. A list of state resources is included on the website for the Autism Society of America at www.autism-society.org. Some parents ask whether they should involve a lawyer in their dealings with the early intervention office or whether they should bring a lawyer to the IFSP meeting....

There are currently several states in the United States that have state mandates where coverage for ASDs is required by law, among them California, Texas, New Jersey, Connecticut, Colorado, and Indiana. These mandates are rooted in state laws that require mental health coverage comparable to benefits received for physical ailments. The insurance mandate for ASDs under Indiana State law now defines ASDs as neurological disorders and covers certain services such as ABA therapy. In Colorado, several health insurance carriers agreed to cover autism as a congenital (birth) defect and pay for 20 visits each of medically necessary treatments for speech, occupational, and physical therapy. However, even if you live in a state where insurance companies are required to cover treatment for ASDs and even if your insurance company has a stated policy of covering treatment for ASDs when required to do so, actually collecting these benefits may require some diligent effort on your part. In a...

When deciding if inclusion is right for your child, according to Sheila Wagner in Inclusive Programming for Elementary Students with Autism, you and the professionals who work with your child will want to take into account the following considerations While inclusion may work well for some children with ASDs, it is not right for every child. One father reported that his daughter started out in a full-inclusion setting, but was then transferred to a special education classroom at the same school. It was too much for her. She was in sensory overload. There were too many kids in the classroom, and it was too loud for her. She started stimming again. Her aide recommended that we move her into a special education class that was smaller. She's doing much better now. Another parent reported that she never even considered inclusion. Our son was too low-functioning. It was never an option. We knew he had to attend a special school for autism.

There is one school of thought that contends that individuals with ASDs, especially those with high-functioning autism and Asperger's, should not be rid of their ASDs. These individuals believe that their ASDs are what makes them special and resent the thought that treatment may remove their quirkiness and idiosyncratic behaviors. This was the focus of the December 20, 2004 New York Times article titled How About Not 'Curing' Us, Some Autistics Are Pleading by Amy Harmon. In response to this article, I wrote a letter to the editor, which appeared in the New York Times on December 22, 2004. Re How About Not 'Curing' Us, Some Autistics Are Pleading (front page, Dec. 20) As the mother of a child who recovered from autism through intensive behavioral treatment, I respect that individual differences and the need for treatment are not mutually exclusive. The article highlighted the school of thought that people with autism should not be treated because their autism is what makes them...

Some children with ASDs do experience what is referred to as recovery. Children who achieve recovery from ASDs no longer meet the criteria outlined in the DSM-IV-TR. They are considered to be no longer on the autism spectrum. Some recovered children still exhibit quirky or idiosyncratic behavior (such as minor finger flicking or tapping) or have other developmental issues (such as slower motor coordination or speech and language impairments). There is also a small percentage of children who experience full recovery and look and act like any other typical child. Jake is one of these children. But when Jake was first pronounced recovered, he still had some catching up to do. While he no longer met any of the criteria for PDD-NOS and had no residual stim-ming or idiosyncratic behaviors, his skills still lagged behind those of other children his own age. Jake did not speak as fluently as his peers, had slower auditory processing, and needed a therapist to support him on play dates. We...

I can't help comparing my child with other kids. At the playground, I compare him with typical kids. Even at his special school for autism, I compare him with other kids with ASDs. Sometimes, I feel hurt that he just isn't doing as well as other kids. What can I do In addition to comparing their children with typical children, parents also tend to compare their children with other children with ASDs. Again, this is not a fair comparison because no two children are the same, even if both are on the autism spectrum. Children with ASDs have different rates of development. One mother of a child in a special school for autism kept parallel tabs on her son's progress and that of another child who started school at the same time as hers. At the end of the school year, she was dismayed to learn that her son was still not speaking, yet the other child was. She began to feel hopeless. But the director of the school reminded her of the many advances her son had accomplished. He no longer had...

When safeguarding your home, first secure the areas that present the most potential danger for your child. Consider your child's behaviors to help you decide. For example, Nathan, who you'll recall was diagnosed with Autistic Disorder, had a propensity for breaking windows. His parents decided to replace the window glass with Plexiglas. Another child was a climber, so his parents made sure there were no heavy bookcases that could be tipped over or medicine cabinets that could be opened. They installed safety locks on all

We didn't have a formal conversation with our daughter to tell her she had autism. We just never hid it. We talked about autism around the house from when she was young so that she and her brother and sister would know about it. It was always a part of our lives, and we wanted

We mostly include my younger sister in everything like going out to dinner and going to family stuff. But once we went to Florida for a long weekend without her. She stayed home with Grandma. I guess once in a while we go to the movies without her. I think that's normal. My friend Pete told me his sister doesn't always go with him when he goes out with his parents and his sister doesn't have autism. We kids have a little bit of trouble having an autistic sibling. The autistic child gets more attention than the others just because he needs more help. Our names are Diane and Scott, and we have an autistic brother that no longer lives with us. Scott and I were not doing as well as we could have in school when my brother was here. This was because our parents were always chasing after our brother in the neighbors' yards, getting him ready, cleaning up the food he threw on the floor, and a lot of other things. So we were never able to study. This gave us no time for what we had to do. For...

My husband and I have always said that we wouldn't let our son's condition define us, so we actually don't purposely seek out other parents of autistic children. Initially, right after the diagnosis, I had a hard time being out with my friends. If they complained about their children, I resented that. How dare they complain about these trivial things their children were doing Their children could speak, couldn't they They had a perfectly normal life ahead of them, didn't they I wanted to scream that out to them, but didn't want to come off as being self-righteous and indignant. This was an initial reaction, and it was based on hurt. I am so fortunate to have my best friend from when I was three years old as a support. I don't know what I'd do without her we've been through a lot of tears together and I truly feel I'm not alone. I would have felt differently if I didn't have her. It's amazing how many new friendships we've formed as a result of autism....

Parents may feel guilty about leaving their child at all, but it's important to spend time focused on yourself and on your relationship with your spouse. You can teach a babysitter or relative how to take care of your child's special needs. You can also contact teachers at local special education schools or contact psychology departments at local colleges for students majoring in special education. Other contacts include your local autism organizations, chapters of ASA or the ARC (formerly known as the Association for Retarded Citizens).

When explaining an ASD to siblings, make sure to take into account their age and comprehension level. Because a two- or three-year-old sibling will not understand the phrase autism spectrum disorder or even the word autism, it's not necessary that you offer an explanation. But he or she can be taught how to play with a brother or sister in ways that won't cause unnecessary upset. For example, a two-year-old can learn to clap her hands rather than pull her brother's hair to get his attention and learn to roll a ball to her brother to interact with him. In fact, siblings of any age can learn appropriate ways to act and interact with a brother or sister with an ASD. With siblings who are six or seven years old, you can use appropriate, simple terms to explain ASDs. In Siblings of Children with Autism A Guide for Families, Sandra Harris and Beth Glasberg describe a creative solution for explaining ASDs to this age group. You can create a book with your child and illustrate it with photos....

There have been news reports of an epidemic of autism. Autism is the fastest-growing serious developmental disability in the United States. It is five times more common than Down syndrome, three times more common than juvenile diabetes, and more common than multiple sclerosis, cystic fibrosis, and childhood cancer. ASDs are not only confined to the United States there are reports of increased rates of diagnoses on a worldwide basis. According to Autism Speaks, the fund-raising drive of an organization called the Autism Coalition -there are 1.77 million cases of autism in the United States -every twenty minutes, a new case of autism is diagnosed and -there are 24,000 new cases of autism in the United States per year When did we first notice an increase in cases of ASDs in the United States In the 1990s, concerned citizens in Brick Township, New Jersey, notified the CDC that there were an extraordinary number of reported cases of autism in their schools. No one knew why. At the same...

There are major areas of study that you should know about, and you'll learn about them soon. But before you read this section, I want to issue you a word of caution Please don't make the mistake of getting so caught up with what caused your child's ASD that you miss out on getting immediate treatment for your child. As much as you may want to find the reason why your child has an ASD, it's important that you attend to what's really important right now. As soon as children are recognized as having any autism spectrum disorder, they should receive intensive intervention, says Catherine Lord, director of the University of Michigan Autism and Communication Disorders Center and an internationally recognized expert in the field of autism. While it's fine to learn some of the basics about potential causes now, you can always research them in more detail later. You will also be able show your support by being involved with autism organizations and universities that are at the forefront of...

The IDEA specifies that a child is legally entitled to receive early intervention services or special education services if the child meets the state eligibility requirements that define disability. Autism is mentioned specifically in the IDEA as a condition that constitutes a disability. Therefore, if your child has been diagnosed with an ASD, this diagnosis is generally sufficient to determine that your child is entitled to the rights afforded by the IDEA.

Children with Autism A Parent's Guide edited by Michael D. Powers, Psy.D. (Bethesda, MD Woodbine House, 2000). This is a comprehensive reference book for parents and practitioners, with chapters written by various experts on child development, daily and family life, medical concerns, educational programs, early intervention, legal rights, advocacy, and more. It also includes parent statements at the end of each chapter and a list of state resources in the appendix. Demystifying Autism Spectrum Disorders A Guide to Diagnosis for Parents and Professionals, by Carolyn Thorwarth Bruey, Psy.D. (Bethesda, MD Woodbine House, 2004). An excellent choice for parents, loved ones, or practitioners who want to further understand a child's diagnosis of ASD and written in language the layperson can understand. Emergence Labeled Autistic by Temple Grandin and Margaret M. Scariano (Novato, CA Arena Press, 1986) and Thinking in Pictures and Other Reports from My Life with Autism by Temple Grandin (New...

And developmental disorders such as autism. Nonetheless, behavioral issues and psychosomatic illnesses are quite common presentations in the urban areas and are well documented in the Indian literature. Psychosomatic presentations commonly encountered in children and adolescents include psue-doseizures, headaches, stomachaches, difficulty in breathing, and limb pain. Alternative traditional modes of treatment, such as yoga, meditation, homeopathy, and Ayurveda (an ancient form of medical practice, primarily using herbs and extracts of various medicinal plants), are often pursued.

The two psychiatric journals that are published in Australia and New Zealand are the Australian and New Zealand Journal of Psychiatry and Australasian Psychiatry. Practice parameters and consensus reports on clinical practice in child psychiatry have been produced by the RANZCP and are available on its Web site. In addition, federal and state governments have also produced guidelines such as treatment guidelines for attention-deficit hyperac-tivity disorder, suicide risk assessment, and early intervention in autism. Health organizations have produced their own guidelines, such as for early intervention in psychosis.

This topic has been covered only briefly in this section and both the tasks above and extra reading below are designed to expand your knowledge sufficiently to answer this question fully. This is an important topic, not only because it tells us something about a 'normal' child's cognitive development but also something about autism. In the introductory paragraph you need to make it clear that you understand the concept of theory of mind and the importance of testing using false belief tasks. Since the question specifically asks you how research has and language in developmental contexts. Springer Series on Human Exceptionality. New York Springer-Verlag. A very recent text which looks at the links between theory of mind and language, the different levels of analysis -both intercultural and intracultural - and the interactions between them. It includes topics such as mental language and emotion, false belief tasks, social theory of mind, relationship between theory of mind and reading,...

Cognitive-extended forms with the help of symbolic language acquisition. Neu-rodevelopmental research into the fundamental mechanisms of consciousness in infants is understandably modest for obvious epistemological ethical reasons, as much of the current neuroscientific work focuses on neural correlates of higher conscious and cognitive activity in adult brains. This suggests that basic research will have to refocus attention on basic neural processes taking place in the first year of life, as core component processes must be brought on-line to operate in an integrated fashion very early in neurodevelopment. Such research into early development will also likely pay dividends clinically in terms of an increased ability to understand and treat disorders of consciousness, such as coma and persistent vegetative state, but also lesser forms of akinetic mutism, autism, and schizophrenia. We suspect that the substrates for the early orienting affective responses of the infant in its...

The accuracy of questionnaires is particularly prone to social, cultural and economic differences among patients. One reason is that a lot can be lost in the translation of questionnaires. However, even if the language used is the same, interpretation and reaction may vary. For example, cognitive tests tend to underestimate the abilities of elderly people from ethnic minorities. This can lead to overdiagnosis of dementia in these communities'15'. The CAGE questionnaire (which is commonly used to detect alcoholism) performed poorly in some ethnic groups, particularly African-American men'16'. Similarly, a questionnaire to detect autism developed in the US and UK could not be used in families in Hong Kong because of perceived cultural differences'17'. These examples (and many more) should lead us to look for local validation studies before accepting the accuracy of diagnostic tests, especially in the form of questionnaires.

The differential diagnosis of OCD includes other psychiatric disorders that are characterized by repetitive behaviors and thoughts. To appropriately diagnose OCD, the content of the obsessions and or compulsions cannot be completely attributed to another psychiatric illness. For example, a diagnosis of anorexia nervosa should be made if a person has only obsessive worries about gaining weight and compulsions that are centered on not allowing the consumption of calorie-containing foods. By the same token, all obsessions or compulsions revolve around a fear of a specific animal, situation, or object, a simple phobia should be diagnosed. The obsessions of OCD must be distinguished from the ruminations of major depression, racing thoughts of mania, and psychotic symptoms of schizophrenia. The compulsions of OCD must be distinguished from the stereotypic movements found in individuals with mental retardation or autism, the tics of Tourette syndrome, the stereotypies of complex partial...

Infants' tendency to turn to follow an adult's gaze. Gaze-following is a critical component of joint visual attention, defined as looking toward the object of another person's attention because it is the object of their attention. Joint visual attention is a particularly important social event because it is thought to be the earliest manifestaion of intersubjectivity, that is, the ability to infer others' mental states (Baron-Cohen, 1995 Tomasello, 1995 Trevarthen &amp Hubley, 1978). It also seems to facilitate language development. Toddlers' vocabulary is predicted by the frequency of mothers' and infants' joint visual attention (Tomasello &amp Todd, 1983). It is also predicted by infants' responsiveness to pointing (Harris, Barlow-Brown, &amp Chasin, 1995 Smith, Adamson, &amp Bakeman, 1988). In addition, failure to respond to others' gaze predicts childhood autism, which is typified by severe language deficits (Loveland &amp Landry, 1986 Mundy, Sigman, &amp Kassari, 1990). Finally,...

Childhood-onset schizophrenia (COS) is a rare psychotic disorder that in certain ways resembles a pervasive developmental disorder. Information on its prevalence is limited, in part because diagnostic criteria have changed considerably over the last decade (Volkmar and Tsatsanis, 2002). COS is almost certainly less prevalent than autism, however, and it is often diagnosed in the presence of an autistic spectrum disorder. Males and females seem equally likely to be affected. Premorbidly, COS is associated with a number of developmental delays, including disturbances in motor, general cognitive, linguistic, and social development (Jacobsen and Rapoport, 1998 Nicolson et al., 2000). Some evidence suggests that the premorbid and clinical courses of COS are more severe than those of later onset schizophrenia (Alaghband-Rad et al., 1995). Episodes are more acute, and on average are of longer duration, in younger compared with older children (Werry, 1996). The course of illness is highly...

More than one in five American children suffers from a diagnosable mental disorder. Drawing upon U.S. Surgeon General estimates, 13 percent of persons younger than 18 have one of nearly a dozen anxiety disorders, 10 percent have conduct disorders, 6 percent have mood disorders, and 3 percent have severe mood and thought disorders, such as bipolar disorder, schizophrenia, and autism.

Therapists say that music therapy can help terminally ill patients decrease anxiety, depression, and pain, and improve ability to sleep and enhance overall quality of life. It helps reduce the need for medication among patients and during childbirth, and distracts dental patients from the pain of root canal. It can improve the ability of mentally handicapped and autistic children to learn, to interact with other people, and to relate to their environments. It enhances the well-being of elderly patients in nursing homes, including those suffering dementia.

Premature babies exposed to music in intensive-care units gain weight more quickly and are discharged more quickly than babies who do not hear music. Music therapy also has been shown to reduce anxiety levels in children undergoing surgical and medical procedures. Research supports the ability of music therapy to increase motor skills developmentally disabled children and assist their capacity to learn math and other subjects. It has been used successfully to strengthen coordination and walking skills among children with muscular or skeletal disorders, to improve the speech of hearing-impaired students, and to lessen the isolation of autism.

As stressed throughout this book, babies and children need social and interpersonal contact with others. They need interactive opportunities to give and receive spoken language, eye contact, and touch as much as they need food and water. However, children with a pervasive developmental disorder, a category that includes autism, have mild to severe limitations in each of these sense-dependent interpersonal abilities. As a result of their disorders, these children often manifest an inability to respond to touch and other forms of interpersonal contact.

While our two research programs differ in their substantive focus, they nevertheless share certain commonalities, which tie them to the study of social integration generally and the sociology of mental health specifically. Both studies, for example, clearly illustrate the critical importance of social integration to successful social adaptation. For the families of autistic children, the availability and use of supportive social ties both reduces stress and promotes child learning and development, while for mentally ill offenders, successful community integration is clearly contingent upon supportive pro-social connections with family members, service providers and even institutions. At the same time, both studies underscore how social networks can erode due to macro and micro social processes. Finally, both studies also point to the ways that supportive social relationships are embedded in the wider social structure in which they occur.

Seizure disorders are also present as part of complex syndromes with neurophysiological and developmental symptoms. Lennox-Gastaut syndrome is responsible for less than 5 of all childhood epilepsies and presents with intractable seizures, deteriorating cognition, autistic spectrum disorders, aggression, and hyperactivity. Landau-Kleffner syndrome is characterized by an acquired epileptic aphasia with onset typically between the ages of 3 and 8 years. There is a receptive aphasia or verbal auditory agnosia with intact hearing. Associated features include hyperactivity, inattention, irritability, and mild motor apraxia. Juvenile myoclonic epilepsy is an idiopathic syndrome that appears in the second disorders (autism and

Children with TSC are at risk for a wide range of psychiatric disorders including anxiety, depression, and disruptive behavioral disorders frequently characterized by temper tantrums and aggression. Mood disorders may initially present with changes in sleep patterns, escalating aggression, or progressive social withdrawal with evidence of extreme shyness. These patients may also be prone to self-injurious behaviors (De Vries et al. 2007). Patients also experience sleep continuity disorders and a variety of specific fears and phobias. TSC is also associated with autism spectrum disorders at rates that are higher than those of any other known genetic disorder (Bolton 2004 Hunt and Shepherd 1993). Patients with TSC are 200-1,000 times more likely to experience autism spectrum disorders than the general population. Conversely, patients with autism are 200-300 times more likely to have TSC than the general population. Although the association is not yet clear, some investigators believe...

Thimerosal is a preservative used in vaccines that has been purported to cause autism in children. The assumption is that thimerosal, also known as ethyl mercury, causes similar effects as methyl mercury, which has neurotoxic and nephrotoxic effects at high-doses. Several epidemiologic studies have not shown a higher rate of autism among children receiving thimerosal-containing vaccines when compared to the normal background rate of autism. Additionally, the mercury exposure with vaccination is much lower than through many other environmental exposures. Despite the lack of evidence of thimerosal causing neurologic disorders, vaccine manufacturers are producing vaccines that are thimerosal-free or only contain trace amounts of 21

For doctors, this growth in patient autonomy has been a double-edged sword. On the one hand, empowered patients can help their doctors give them the best treatment possible for their ailments. On the other hand, as Alexander Pope so famously noted in his Essay on Criticism, a little learning is a dangerous thing. For example, unfounded public fears that vaccines cause autism have been linked to rumors spread via the Internet (Zimmerman et al. 2005). There is an abundance of inaccurate medical information on the Web, and Internet pharmacies often sell dangerous drugs without providing the warnings or monitoring that would normally apply in a traditional doctor-patient relationship. Researchers in Europe found a range of medical misinformation (i.e., in one site, a product containing a powerful monoamine oxidase inhibitor compound was offered to clients without any warning regarding side effects and interactions) (Schifano et al. 2003, p. 409). Antipsychiatry groups such as the...

The vast majority of colloid cysts are sporadic. Mathiesen et al reported a mother and son who both had colloid cysts and noted two reports in the literature of twins and nontwin brothers with colloid cysts.29 Tada and Nakamura described a patient with basal encephalomeningocele, anophthalmia, agenesis of the corpus callosum, and colloid cyst.46 They found 13 cases in the literature with encephalomeningocele and 7 with agenesis of the corpus callosum and ocular abnormalities but none with colloid cysts. One 15-year-old female with Asperger's syndrome (a variant of autism) and ligamentous laxity had a lesion consistent with a colloid cyst on a routine CT scan.47 A 14-year-old female with nevoid basal cell carcinoma had a symptomatic colloid cyst removed transcallosally.35 This syndrome includes multiple nevoid basal cell epitheliomas, jaw cysts, bifid ribs, cerebellar medulloblastoma and calcification of the dura, meningiomas, hydrocephalus, and partial agenesis of the corpus callosum.

At present, the only neuropeptidergic drugs that are approved for treating psychiatri-cally significant living problems are those that antagonize opioid receptors, for instance, naloxone and naltrexone. Their first approved use was in the treatment of narcotic overdoses as well as maintenance of opiate abstinence. Subsequent work indicated significant efficacy in the treatment of alcohol craving (O'Malley et al., 2002), which may reflect a general reduction in reward craving (de Wit etal., 1999) that extends even to gambling urges (Kim and Grant, 2001) and perhaps binge eating as well (Marrazzi et al., 1995). However, as we will discuss toward the end of this chapter, there have also been some off-label uses, such as for the treatment of self-injurious behaviors as well as certain symptoms of early childhood autism (Aman and Langworthy, 2000 Chabane et al., 2000). One can envision many additional indications, perhaps the most extreme being as a treatment for maladaptive...

The first theoretically driven hypothesis concerning a neuropeptidergic imbalance in a major psychiatric disorder was the opioid-excess theory of early childhood autism (Panksepp, 1979). This idea, although now evaluated many times, remains neither well confirmed nor adequately disconfirmed. The second, ADHD, the most prevalent childhood problem of our times, can be well-managed pharmacologically, but there is

Cognitive tests are included in a standard forensic battery of tests because of their diagnostic utility. They assess how a person thinks, as well as provide an estimate of intelligence. The tests identify disorders in thinking, including formal thought disorders, attention and concentration impairments, and variation in capacity that can be pathognomonic of autism and other developmental spectrum disorders. Performance on the cognitive tests can also detect problem-solving style and obsessive-compulsive and paranoid characteristics.

Children with untreated or poorly managed PKU usually end up in institutions. A review of 51 never-treated patients followed for more than 20 years indicated 25 percent had seizures disorders, half were profoundly retarded, and about half were moderately impaired. y Approximately two thirds of untreated patients develop microcephaly. Autistic behavior may also emerge. Aggressive, hyperactive behavior is common in poorly managed patients, which becomes less noticeable on lowering the blood phenylalanine level. In well-controlled patients, ingestion of food with high phenylalanine content, at any time during life, will cause confusion and a clear-cut fall in school performance. Other common causes of childhood mental retardation include hyperprolinemia, homocystinuria, and fragile X- syndrome. Clinically, hyperprolinemia cannot be distinguished from mild PKU except by the amino acid analysis. Patients with a missed diagnosis of homocystinuria will have its classic phenotype, which is...

The publication of the book Emotional Intelligence by Daniel Goleman in 1995 led to the sudden popularisation of the earlier proposal for the concept of emotional intelligence by Salovey and Mayer (1990), which in turn was based on earlier proposals such as Gardner's (1983) concept of social intelligence. The popularisation has led to the assessment and teaching of emotional skills in the workplace and in schools, while academically it has remained surrounded by controversy. The main arguments against the proposal (e.g., Davies, Stankov, &amp Roberts, 1998 Roberts, Zeidner, &amp Matthews, 2001) are that there is nothing unique in the proposal that is not already covered by existing approaches to personality theory and existing approaches to intelligence. Our own view is that the term emotional intelligence is one that is best avoided because of its value-laden and elitist implications, but that there clearly are variations in emotional skills that should not be ignored. The...

The authors conclude that the molecular genetic findings support the assumption that high dopamine levels in the prefrontal cortex are associated with higher cognitive abilities. However, it has to be mentioned that the total dopamine activity is not only influenced by the dopamine catabolism but also by the synthesis rate of dopamine in the presynapse, the activity of the dopamine transporter, the receptor density, and the receptor affinity. DRD2 TAQIA, the second polymorphism under investigation, has been studied with respect to intelligence but the results were heterogenous. One study reported a higher IQ in carriers of the A1A1 genotype in a female Taiwanese sample, Berman and Noble found a significant reduction in visuospatial performance in a sample of Caucasian children and Petrill et al. found no association between IQ and the DRD2 gene in an adult Caucasian sample. The rationale for investigating the TPH A779C polymorphism, a serotonergic SNP, with respect...

Readers of this article - especially those interested in their own creativity - face the uncomfortable prospect that creativity is intricately related to psychopathology. This includes the potential relationship of mathematical creativity with autism, artistic creativity with bipolar disorder, and general creativity with schizophrenia. Such a notion appears in various guises in both the literature and the media the 'madman in the attic,' the 'mad genius,' the 'sensitive artist,' the 'troubled artist,' the 'deranged scientist,' and so forth. Biographical studies of various eminent individuals - artists, poets, musicians, scientists, explorers - discuss their creativity and their pathology, implying that their productivity comes at a personal price and that there is a genetic basis to both creativity and 'madness.' Thus, from the very outset, one has to consider such Romantic ideas concerning the 'troubled artist,' the notion of deviance - in both the positive (creativity) and negative...

We will cover the last emotional system in Table 21.1, playfulness, in the next section, as we consider two of the most controversial childhood psychiatric problems of our times, autism and attention deficit hyperactivity disorder (ADHD). The first has no adequate, generally accepted medications (although many psychotropics provide relief of specific symptoms), while the other has many adequate medicines, but professionals who prescribe them express little appreciation of the potential long-term brain mind changes that can be provoked in animals with psychostimulants such as methylphenidate and amphetamines (Moll et al., 2001 Nocjar and Panksepp, 2002).

Different types of scatter are associated with different psychiatric problems. For example, within subtests, scatter occurs when a person gets some easy items wrong and some hard items correct that is, performance is irregular. That pattern can be a sign of attention deficit, distractibility related to anxiety, trauma, depression, and psychosis. Scatter between domains, in which the verbal domain is over 15 points higher than the perceptual and processing domains, is an indicator of a performance learning disability associated with Asperger's syndrome and autism. Here is an example of intratest scatter associated with psychosis from answers on the vocabulary test

Megavitamin therapists treat patients who have cancer, as well as those suffering from diabetes, schizophrenia, AIDS, pneumonia, flu, learning disabilities, depression, aging, autism, skin problems, hyperactivity, mental retardation, arthritis, and other diseases. The American Psychiatric Association and the NIH issued statements about megavitamin or orthomolecular therapies for psychiatric diseases, calling them and their unsubstantiated promotion ineffective, harmful, and deplorable.

Before turning to modern biological psychiatry, it is worth noting that the middle, psychoanalytic era, with its neglect of robust research agendas, allowed mere ideas, often endlessly debatable, too much influence on psychiatric thought. In a sense, this was also a magical fantasy era. Dramatic new somatic therapies, based on marginal research findings, flourished. Perhaps the Reichian concept of libidinal orgone energy and the resulting orgone box (to concentrate that energy) could be taken as symbolic of this era Willhelm Reich (1897-1957), whose own mental stability was eventually questioned, was convicted of fraudulent claims and died during his incarceration in a federal penitentiary. Others, like Bruno Bettelheim, generated needless guilt with concepts such as refrigerator mothering, which allegedly was instrumental in causing early childhood autism. It took many years for that needless guilt trip to become an embarrassment to the discipline (e.g., Pollak, 1997).

In addition to these five epidemic afflictions, other illnesses were common among the populace. According to The Pillow Book, a series of essays written by a lady at court (Sei Shonagon) about the year 1000, the three diseases most feared by the tiny coterie of aristocrats at the Heian court were chest trouble (munenoke), evil spirits (mononoke), and beriberi (ashinoke). Chest trouble undoubtedly refers to tuberculosis, although Hattori (1975) suspects that heart-related afflictions were also common. Tuberculosis is one of the oldest diseases known to humanity, and it may have been that because the tuberculosis bacillus is often transmitted via unpasteurized milk, the aristocracy contracted the malady by eating a yogurtlike food product of which they were fond. Evil spirits suggest mental illnesses, and Hattori (1975) has found evidence of schizophrenia, autism, and manic-depressive behavior in the imperial line. Beriberi, a disease caused by a deficiency of thiamine (probably due to...

Schizophrenia and schizotypy are both characterized along the same two dimensions - one referring to the positive symptoms (e.g., delusions, hallucinations, etc.), the other to the negative symptoms (e.g., anhedonia, flat affect, etc.) of these phenomena. What do we know about the relationship between schizophrenia and normative (or, dimensional) schi-zotypy And what do we know about that between schizotypy and creativity that can shed light on the schizophrenia-creativity relationship A number of studies have reported a relationship between the positive and negative symptoms of schizophrenia, and their counterparts in nonpsychotic relatives. One study indicated that the relationship was stronger for the negative symptoms than for the positive ones. Other studies have found that positive schizotypy is associated with better performance on measures of creativity (in particular, measures of divergent thinking), while negative schizotypy is associated with better performance on measures...

Myoclonus with hypsarrhythmia but may gradually evolve into grand mal or psychomotor epilepsy. Many of these patients have features of autism rarely, there may be chorea and atheto-sis. With time higher mental function deteriorates. Approximately two thirds of patients with normal mental function have seizures. On the other hand, all patients with mental retardation suffer seizure disorders.19 A loose correlation exists between a large number of cortical lesions, developmental delay, and poor seizure control.

Kasari and colleagues in a randomized controlled study with autistic children, found that a play intervention resulted in increased symbolic play. This was a very rigorous study that began the intervention at the child's current developmental level of play. The training involved modeling and prompting. Children in the play group, compared with the joint attention and control groups, showed increased symbolic play that generalized to play with the mothers. This study is relevant to creativity because children with autism have deficient pretend play skills. Techniques that facilitate play in these children should be effective with other groups as well.

In their review of six cases of posttraumatic psychosis De Mol, Violon, and Bri-haye (1982) noted that the presentation of psychosis following injury principally consisted of delusion, hallucination, the presence of paranoid and mystical ideas, autism, psychomotor instability, and fugues. They noted that the demography of the condition indicated that it occurred mostly in young men before the age of 30. The severity of the TBI did not predict the likelihood of the condition and the temporal lobes were implicated in one third of their sample.

In discussing pets as therapy, one tends to relate to the health-giving aspects alone, but pets have also been found to have a therapeutic effect in education. Researchers in Austria discovered that the presence of a dog in a primary school class helped disruptive children to concentrate more on their lessons and to become less boisterous and attention seeking (Le Fevre 2004). A wide range of animals, including dogs, ponies and even pigs, have been introduced into schools for children with autism and severe learning difficulties. As well as being educational in terms of learning about body parts and nature, these animals have brought many psychological benefits by improving self-esteem, teaching nurturance and inducing a more empathic attitude towards other peoples' needs.

The motor examination may reveal several signs relevant to the assessment of mood and thought. Any abnormality such as a hemiparesis indicates an organic disorder. The finding of myoclonus or asterixis generally indicates a metabolic or toxic disorder and occurs only rarely with focal lesions. Tremor at rest is seen with neuroleptic drug use or Parkinson's disease, and these should be considered. Rigidity and akinesia should also be assessed they may accompany catatonia, neuroleptic use, or any parkinsonian syndrome. Catatonic akinesia may include waxy flexibility and abnormal sustained postures including one limb being stretched out for extended periods. Adventitious movements such as chorea may be seen and usually indicate tardive dyskinesia following chronic exposure to dopamine-blocking drugs. Alternative explanations include dyskinesias in the presence of psychosisin Pd, Huntington's disease, Sydenham's chorea, or systemic lupus erythematosus....

In 1912, Weinberg noted that the skeletal disorder achondroplasia was prominent in younger rather than older siblings he was the first to suggest the possible link between paternal age and genetic diseases in offspring 4 . Thus, despite the ability of men to father children well into old age, there appears to be a positive relationship between paternal age and genetic disease in their offspring 50 . Older men have greater difficulties in achieving full-term pregnancy with their partners increasing paternal age is associated with a reduction in the quality of spermatozoa, i.e., decline in sperm motility and morphology 51 and a higher incidence of DNA fragmentation 52 there are inconsistent reports as to whether, in man, there is a decline in sperm production rate with advancing age 53 . However, fathers over 40 have both a greater difficulty to conceive 54-56 and their partners have a higher miscarriage rate 57 . With respect to genetic diseases, increased incidences of disorders such...

Abstract There is increasing evidence that the male reproductive system declines with advancing age Studies examining germ cells of older men have raised concerns regarding several aspects of germ cell quality. Increasing paternal age has been linked to genetic diseases (achondroplasia, Apert syndrome, and Marfan syndrome) in the offspring of these fathers the incidence of autism and schizophrenia is also associated with increasing paternal age. Men above the age of 35 have increased incidences of anneuploidy in their sperm, decreased sperm motility, and increased chromatin aberrations in sperm associated with further problems such as decreased pregnancy rate in the partners of older males. In several tissues, aging is associated with oxidative stress. Rodent studies show that aging male germ cells display an increase in reactive oxygen species (ROS) and a reduction in the antioxidant enzymes normally present to neutralize ROS and protect the cellular structures against ROS-induced...

Mystics describe many weird experiences, such as the feeling of transcending human consciousness, experiencing the presence of God, sensing being at one with the divine, a feeling of absolute dependence, experiencing the transcendent and mysterious reality of the universe, communicating with a world beyond normal experience, etc. The nature of these experiences seems akin to the experiences and feelings reported by some schizophrenic patients. Mysticism is a form of avoidance, a way to escape the harsh realities of a hostile environment that cannot be controlled 4 . Mysticism in this age seems like a form of adult autism, an abnormal introversion with egocentricity, and an escape into a fantasy that for some is more acceptable than reality.

Moreover, compared with individuals with type 1 diabetes, children and adolescents with type 2 diabetes have been shown to have a higher likelihood of being obese, being from an ethnic-minority group, and having lower socioeconomic status (Brody et al. 2008 Degazon and Parker 2007). Therefore, these individuals present with additional challenges beyond their illness. Discrimination and disparities in health care resources for ethnic minorities are well documented (Ahmed et al. 2007). Additionally, individuals who are obese have been shown to have psychological and emotional problems such as depression, low self-esteem, and discrimination (Braet et al. 1997 Miller and Downey 1999 Puhl and Brownell 2001). In a chart review of pediatric patients in Philadelphia, comorbid neuropsychiatric disorders, including attention-deficit hyperactivity disorder, autism, bipolar disorder, obsessive-compulsive disorder, and depression (among others), were found in 19.4 of children at the initial onset...

Vaccines have become victims of their own success (Cooper et al., 2008). Because they no longer are confronted with the presence of vaccine-preventable diseases, some individuals, parents, and groups have become more concerned about the alleged adverse effects of immunization. A Danish study is one of many that has confirmed the effectiveness of vaccines such Hib and pertussis and did not find an association of MMR or thimerosal-containing vaccines with autism spectrum disorders (Hviid, 2006). Physicians serve as the primary source of information about immunizations, and the family physician should explain the potential benefits and risks of immunizations to parents and older patients such as adolescents (Gellin et al., 2000). If parents still do not wish

As of 1980 the DSM outlined the following categories disorders of childhood or infancy (hyperactivity, anorexia, retardation, autism) known organic cause (diseases of old age, drug-induced) disorders of schizophrenia (disorganized, catatonia, paranoid, undifferentiated) paranoid disorders (without schizophrenic signs) affective disorders (bipolar, major depressive) anxiety disorders (phobias, obsessive-compulsive) somatoform (conversion disorder, hypochondriasis) dissociative (fugue states, amnesia, multiple personality) and personality disorders. Perhaps the most controversial change in the new approach was the elimination of the category of psycho-neuroses. In the atheoretical approach, disorders were grouped according to symptoms, not underlying psychic mechanism. Neurotic disorders thus resolve into various forms of anxiety states. Also removed was the heading of psychosis, which had included the major affective disorders experience showed that many patients labeled psychotic did...

Schizophrenia should be differentiated from other primary psychiatric disorders that may have psychosis as a feature, including schizoaffective disorder, the major affective disorders, autism, malingering, and obsessive-compulsive disorder. Symptoms of psychosis can be caused by a large number of medical and neurological conditions and may be precipitated by legal and illicit drugs ( TabJe.3-3 ). Psychosis and other psychiatric symptoms may present

IQ scores or developmental histories before the onset of their seizures. The proportion of retarded patients increases with age because of the deterioration that often occurs in LGS.17 Rarely, a few patients escape mental retardation.17 Marked fluctuations in cognitive abilities occur in LGS patients and are, to some degree, correlated with the intensity of EEG abnormalities. In addition to cognitive difficulties, behavioral problems are common in LGS, ranging from hyperactivity with aggressive behavior to frank psychotic and autistic behavior. In addition to mental retardation and behavioral problems, neurologic abnormalities have been reported in 30-88 of patients with LGS.18-20-89 In addition to aphasia, the majority of patients have behavioral and psychomotor disturbances that may suggest autism. The neurologic examination findings, other than those from the mental status examination, are usually normal.

First, not all risk factors of interest will vary between individuals within the study population. A factor which is universal in the study population, even if it participates in causing disease, cannot be readily examined in this framework. An interesting example of this limitation has emerged in studies of autism. One hypothesis that has been put forward and received much publicity is that childhood measles, mumps, and rubella (MMR) immunizations may play a role in some cases of autism (e.g., Wakefield et al., 1998). In developed countries, however, childhood MMR immunizations is government policy and nearly universal, so that there is little or no interindividual variation on this exposure. For a rare disease such as autism, it may be infeasible to collect a large enough cohort of individuals unexposed to MMR for comparison with a cohort of individuals exposed to MMR. In a case - control design, similarly, almost all cases and controls will be exposed to MMR, so it may not be...

Developmental screening should be part of each well-child examination. The Denver Developmental Screening tools have often been used for this purpose but they lack sensitivity and specificity for autism. The AAP provides a thorough examination of screening instruments for autism (Johnson and Myers, 2007). A variety of screening tools aimed specifically at autism are available but also lack sensitivity (Bryson et al., 2003). Therefore, physicians should take parental concerns about delayed speech and language development seriously, especially beyond 18 months of age, even in the context of normal screening. In addition to delayed speech development, the other common presenting symptom is challenging behavior. The behaviors may include a violent reaction to minor changes in the environment or routine, stereotypic movements such as clapping or rocking, and preoccupation with narrow interests or inanimate objects. When autism is suspected, a thorough evaluation should be performed,...

Ple, staff may solicit input regarding management of a patient who, at baseline, carries a diagnosis of autism and often exhibits self-injurious behavior and who might have particular difficulties in the PICU with sensory stimuli such as vital sign leads and noisy medical equipment. In such situations, the psychiatric consultant may speak with the patient and or family about strategies and supports that have been effective in other settings and may provide staff with psychoeducation and guidance for managing behaviors that might interfere with optimal medical care and practice.

Rett syndrome (RS) has a prevalence of 1 in 10,000. Although first accepted as a distinct clinical entity only in 1983, progress in understanding the pathophysiology of RS has been spectacular. The phenotype of RS falls within the autism spectrum. Unlike autism, however, the symptoms of RS typically emerge only after a period of normal development, and they affect females almost exclusively. One of the most common first symptoms is the loss of purposeful hand movements, which are often replaced by incessant hand-wringing. Other symptoms and signs soon emerge. An arrest of language development and profound cognitive delays are seen in the majority. Play and motor skills are lost in more than half the cases. Regression most commonly occurs between 12 and 18 months of age, but it can be noted as early as 6 months or as late as 36 months (Charman et al., 2002). Growth retardation, microcephaly, ataxia, gait disturbance, and seizures are also common (Hagberg, 2002). The EEG in RS children...

With a prevalence of 1 in 20,000, Williams syndrome (WS) is a rare clinical diagnosis. Nevertheless, it is of considerable interest to clinicians and researchers because of its unique phenotype and the genetic mechanisms that produce it. The pheno-type of WS is almost a mirror image of the phenotype of autism. These children are often outgoing, social, and communicative, and many have a special propensity for music, dance, and simple but highly embellished forms of storytelling. Children with WS are typically small, and they often have pixyish facial features, including a broad forehead, prominent ears, full lips, an upturned nose, and a small chin. IQ averages about 50, but the range is considerable and in some children IQ can be within the normal range. The cognitive profile in WS children is distinctive and includes prominent deficits in visuospatial skills. Relative strengths are seen in more verbal domains, including vocabulary, the social use of language, auditory memory, as...

The genetic liability underlying each of these conditions seems uniquely to affect particular neural systems in each of the disorders. Mesial temporal lobe structures that subserve socialization functions seem to be especially important in autism arrest of development of the association cortices caused by the MeCP2 deletion may generate the symptoms of Rett syndrome the hippocampus and other regions involved in learning and memory are important in fragile X and disturbances in parietal cortices likely subserve visuospatial deficits affecting children with Williams syndrome. Abnormalities in frontal, temporal, and possibly parietal lobes likely subserve the psychotic symptoms and cognitive disturbances observed in childhood-onset schizophrenia. Disturbances in the structure and function of particular portions of CSTC circuits seem to underlie the symptoms of Tourette syndrome, obsessive-compulsive disorder, and attention deficit hyperactivity disorder the portions of the circuits...

Music therapy is an established health profession that aims to help people who have difficulties with social, physical, mental and emotional functions such as communication, cognitive functioning, learning difficulties, autism, dementia, and depression. Because music is such a powerful communication medium, it can sometimes be used to interact with a client when attempts to do so through words alone have failed. Following an assessment of the client's needs the music therapist, who is a skilled and experienced musician, will use a range of musical styles including improvisation, to try and establish interaction with the client. The music that is successful may provide an indication of the client's prevailing mood. The practitioner can then manipulate the music to facilitate positive outcomes such as mood improvement and confidence, and encourage transfer of these to other aspects of the client's life. Song writing, singing, or other musical performances may also be introduced as part...

This disorder shares many characteristics with autism. Children with Asperger's syndrome function at a higher level than autistic children. As with autistic children, they have problems with interpersonal and social relationships. They have little empathy with others and prefer solitary play. Many of these children strongly prefer interacting with objects to playing with or near other children. They tend to count things and focus on patterns. Unlike autistic children, Asperger's children are usually proficient with language. They often talk by the age of 2. As they grow older, their speech patterns take on

In other cases, proponents of alternative biologicals take a therapy used in conventional medicine and extend it to conditions for which it has not been proven effective. Chelation therapy, for example, is an accepted treatment for lead poisoning, but not for heart disease or autism as it is promoted by alternative therapists. Moreover, the mechanism of action proposed for chelation therapy by its advocates is inconsistent with current scientific understanding of heart disease.

Stereotyped motor behavior can occur in normal children and in children with a variety of other primary neurodegenerative conditions. Repetitive head banging, an example of stereotypic activity, is seen in 15 percent of normal children. y In addition, thumb sucking, rocking, and other ritualistic behaviors are common during childhood. Most stereotypies, however, represent evidence of underlying brain dysfunction and hence require recognition. Stereotypic movements occur in at least a third of mentally retarded patients and are a characteristic feature of various autistic disorders such as infantile autism and Rett's, Angleman's, and Asperger's syndromes.y In all these conditions, stereotypies present as repetitive, coordinated, purposeless, involuntary movements such as chewing, lip smacking, body rocking, shoulder shrugging, marching in place, shifting of weight, and thrusting movements of the trunk and pelvis. Respiratory dyskinesia can produce grunting vocalizations,...

Fragile X, a relatively common form of mental retardation caused by a single mutation in the long arm of the X chromosome, occurs once in every 2000 to 4000 live births. Approximately 20 percent of such children exhibit autistic symptoms. Conversely, 8 percent of males and 6 percent of females diagnosed with autism carry the fragile X abnormality. The mutation alters brain development and produces a distinctive physical, cognitive, and neuropsychiatric phenotype. Clinical symptoms are insufficient to make the fragile X diagnosis. Instead, specific genetic abnormality must be evident using molecular diagnostic techniques (Hagerman, 1999).